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Wegovy
semaglutide
Black Box Warnings .
Thyroid C-cell Tumor Risk
contraindicated in patients with medullary thyroid carcinoma (MTC) history or family history, or in patients with multiple endocrine neoplasia syndrome type 2 (MEN 2); dose-related and duration-dependent incr. in thyroid C-cell tumor incidence observed in rodents, but human relevance unknown; uncertain value of routine serum calcitonin or thyroid ultrasound monitoring; advise patients of potential MTC risk and thyroid tumor symptoms (e.g., neck mass, dysphagia, dyspnea, persistent hoarseness)
Adult Dosing .
Dosage forms: TAB: 1.5 mg, 4 mg, 9 mg, 25 mg; INJ (pen): 0.25 mg per injection, 0.5 mg per injection, 1 mg per injection, 1.7 mg per injection, 2.4 mg per injection
weight management, chronic - obese patients or overweight patients with weight-related comorbidity
- [SC route]
- Dose: 1.7-2.4 mg SC qwk; Start: 0.25 mg SC qwk x4wk, then 0.5 mg SC qwk x4wk, then 1 mg SC qwk x4wk, then 1.7 mg SC qwk x4wk, then may incr. to 2.4 mg SC qwk; Info: may delay dose titration x4wk if intolerance; may switch from 2.4 mg SC qwk to 25 mg PO qam 1wk after last injection
- [PO route]
- Dose: 25 mg PO qam; Start: 1.5 mg PO qam x30 days, then 4 mg PO qam x30 days, then 9 mg PO qam x30 days; Info: give on empty stomach with up to 4 oz water >30min before food/drink/med; do not cut/crush/chew tab; may delay dose titration if intolerance; may switch from 25 mg PO qam to 2.4 mg SC qwk (or 1.7 mg SC qwk if 25 mg PO qam not tolerated) day after last PO dose
cardiovascular event risk reduction - obese or overweight patients with established cardiovascular disease
- [SC route]
- Dose: 1.7-2.4 mg SC qwk; Start: 0.25 mg SC qwk x4wk, then 0.5 mg SC qwk x4wk, then 1 mg SC qwk x4wk, then 1.7 mg SC qwk x4wk, then may incr. to 2.4 mg SC qwk; Info: may delay dose titration x4wk if intolerance; may switch from 2.4 mg SC qwk to 25 mg PO qam 1wk after last injection
- [PO route]
- Dose: 25 mg PO qam; Start: 1.5 mg PO qam x30 days, then 4 mg PO qam x30 days, then 9 mg PO qam x30 days; Info: give on empty stomach with up to 4 oz water >30min before food/drink/med; do not cut/crush/chew tab; may delay dose titration if intolerance; may switch from 25 mg PO qam to 2.4 mg SC qwk (or 1.7 mg SC qwk if 25 mg PO qam not tolerated) day after last PO dose
metabolic dysfunction-associated steatohepatitis, patients with stage F2-F3 fibrosis
- [2.4 mg SC qwk]
- Start: 0.25 mg SC qwk x4wk, then 0.5 mg SC qwk x4wk, then 1 mg SC qwk x4wk, then 1.7 mg SC qwk x4wk; Info: may delay dose titration x4wk or decr. maintenance dose to 1.7 mg SC qwk if intolerance
renal dosing
- [see below]
- renal impairment: no adjustment
- HD/PD: not defined
hepatic dosing
- [no adjustment]
Peds Dosing .
- Dosage forms: INJ (pen): 0.25 mg per injection, 0.5 mg per injection, 1 mg per injection, 1.7 mg per injection, 2.4 mg per injection
weight management, chronic - obese patients
- [12 yo and older]
- Dose: 1.7-2.4 mg SC qwk; Start: 0.25 mg SC qwk x4wk, then 0.5 mg SC qwk x4wk, then 1 mg SC qwk x4wk, then 1.7 mg SC qwk x4wk, then may incr. to 2.4 mg SC qwk; Info: may delay dose titration x4wk if intolerance
renal dosing
- [see below]
- renal impairment: no adjustment
- HD/PD: not defined
hepatic dosing
- [no adjustment]